16-18 Partner School Enrolment Form 2022/23

16-18 Partner-School Enrolment Form 2022/23

This form must be completed by the learner. This enrolment form should only be completed by a learner who is attached to a home school and is aged 16-18.

Section 1 - Learner Personal Details

Please enter your legal FIRST NAME:

Please enter your legal SURNAME:

Current Year Group:

E-mail Address:

Sex:

Date of Birth

First line of your address:

Postcode

Next of Kin Name:

You may be provided with a uniform to wear for your course, please let us know your size:

Title

National Insurance Number

Gender:

Name of Home School:

Mobile telephone number:

Landline telephone number:

Next of Kin Relationship to you:

Next of Kin Email Address:

Next of Kin Contact Number:

Section 2 - GCSE Exams & Courses being studied or recently completed

How many qualifications are you expecting to hold prior to joining Achievement Training?

Subject 1:

Subject 2:

Subject 3:

Subject 4:

Subject 5:

Subject 6:

Subject 7:

Subject 8:

Grade / Predicted Grade 1:

Grade / Predicted Grade 2:

Grade / Predicted Grade 3:

Grade / Predicted Grade 4:

Grade / Predicted Grade 5:

Grade / Predicted Grade 6:

Grade / Predicted Grade 7:

Grade / Predicted Grade 8:

Section 3 - Course you are enrolling on:

Course Name:

Vocational Aim:

Employability Aim:

Attendance Day 1:

Attendance Day 2:

FL Animal Care- Tutor: Dave Downie & Carol Couling

Foundation learning- Tutor: Carol Couling

16BT2A - Tutor: Joanne Clayton

16AC2A - Tutor: Dave Downie

16CC3A/B - Tutor: Lena Morgan

16AC2B - Tutor: Hayley Coombes

16IT2A - Tutor: Matt Grice

16CC3C - Tutor: Rachel Bush

16BS2A - Tutor: Jane Wilkinson

16BS3A - Tutor: Katie O'Connor

16IT2B - Tutor: Matt Grice

16AC3B - Tutors: Aimee Tippett / Hayley Coombes

16AC3A - Tutor: Sarah Lomax

16BT2B - Tutor: Chloe Gregory

16BT3A - Tutor: Beccy Young

16BT3B - Tutor: Chloe Gregory

16HR2A - Tutor: Martyne Johnson

16HR3A - Tutor: Michelle Tippett

16NT3A - Tutor: Claire Lambert

Section 4 - Additional Details:

Please provide ATL with the reasons you wish to undertake this course:

Do you have any of the following learning difficulties / disabilities ?

Visual impairment

Hearing impairment

Disability affecting mobility

Profound complex disabilities

Social and Emotional difficulties

Mental health difficulty

Moderate learning difficulty

Severe learning difficulty

Dyslexia

Dyscalculia

Autism spectrum disorder

Asperger's Syndrome

Temporary disability after illness

Speech, Language and Communication needs

Other physical disability

Other specific learning difficulty (e.g. Dyspraxia)

Other medical condition (for example epilepsy, asthma, diabetes)

Other learning difficulty

Other disability

Prefer not to say

None

Have you ever held an EHCP (Educational health care plan) or 139a / statement?

Yes

Would you like the Learner Support Manager to contact you to discuss any queries you may have?

Please use this area to provide any additional information:

Section 5 - Learner Declarations:

Your personal information is used by the DfE to exercise its functions and to meet its statutory responsibilities, including under the Apprenticeships, Skills, Children and Learning Act 2009 and to create and maintain a unique learner number (ULN) and a personal learning record (PLR). Your information will be securely destroyed after it is no longer required for these purposes. Your information may be shared with third parties for education, training, employment and well-being related purposes, including for research. This will only take place where the law allows it and the sharing is in compliance with the data protection legislation. You can agree to be contacted for other purposes by selecting one of the below:

I consent to Achievement Training Limited, CSW Group and City College Plymouth processing my personal data under Data Protection legislation in accordance with Article 6 with my consent and to process my information and understand that this is for the performance of the contract in relation to the course that I have applied for, I acknowledge that specific details of processing activities undertaken by ATL and City College Plymouth is available on the Achievement Training Limited website. By submitting this form I agree to Achievement Training processing the personal data on this form in accordance with prevailing Data Protection legislation. You can agree to be contacted by Achievement Training for other purposes by ticking any of the following boxes:

LRS (Learning Records Service) - The information you supply will be used by the Education and Skills Funding Agency, an Executive Agency of the Department for Business, Innovation and Skills, to issue you with a ULN (Unique Learner Number), and to create your personal learning record. For more information about how your information is processed and shared refer to the Extended Privacy Notice available on Gov.uk (The LRS privacy notice is available to view here: https://bit.ly/2xQNzk8), you cannot opt out, you can however opt-in to sharing your participation and achievement data through the Learning Records Service by ticking below:

Opt-in to share personal learning record

Learner Signature

Sign Here

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